| Objective:The aim of this study is to compare the sensitivity of fast spin-echo T1-weighted contrast agent enhancement(CE-T1 WI FSE),three-dimensional fast gradient echo T1-weighted contrast agent enhancement(3D CE-T1 WI FFE)and three-dimensional(3D)contrast-enhanced T1-weighted flow-sensitive black-blood sequence(3D CE-T1 WI FSBB)in the detection of brain metastases from lung cancer.To explore the application value of 3D CE-T1 WI FSBB sequence in the detection of brain metastases of lung cancer.Methods:A total of 60 patients with brain metastases from lung cancer confirmed by clinical data combined with imaging examination data in the Affiliated Tumor Hospital of Guizhou Medical University from January 2021 to August 2022 were retrospectively analyzed.Lung cancer was divided into common types according to pathological types,including lung 46 cases of adenocarcinoma,6 cases of small cell lung cancer,7 cases of squamous carcinoma,1 case lung adenosquamous carcinoma and so on.Patients underwent 3.0T Magnetic Resonance Imaging(MRI)scans of the head(axial T2 WI,T1WI,T2 WI FLAIR and sagittal T2WI),conventional CE-T1 WI FSE,3D CE-T1 WI FSBB and 3D CE-T1 WI FFE scans.Two radiologists scored each lesion(CS)according to the conspicuousness of brain metastases from lung cancer in each patient and grouped them according to different diameters(≤3mm,3-10 mm,≧10mm).The score,location,maximum diameter(mm),the number of signal intensity differences between 3D CE-T1 WI FFE3D and CE-T1 WI FSBB and the enhancement pattern of brain metastases were observed and recorded on the three sequences.IBM SPSS version 22.0 statistical software was used to observe the results.The drawing software was R(Version 4.2.2).Analysis of variance or Kruskal-Wallis H test was used to determine whether the overall difference was statistically significant(P<0.05).Bonferroni method was then used to compare the difference between the mean score ± standard deviation among the CE-T1 WI FSE、3D CE-T1 WI FFE and 3D CE-T1 WI FSBB sequences in pairs,and P<0.05 was considered statistically significant.Results:1.A total of 320 lesions were detected by the three sequences in 60 patients.The sensitivity(CS≧2)of 3D CE-T1 WI FSBB、3D CE-T1 WI FFE and CE-T1 WI FSE were 98.4%,95.6% and 72.2%,respectively.2.The mean score(CS)± standard deviation(SD)of CE-T1 WI FSE 、 3D CE-T1 WI FSBB and 3D CE-T1 WI FFE were 2.11±1.02、2.87±0.46 and 2.79±0.59,respectively.Bonferroni method was used for multiple comparison analysis of the mean CS±SD of the three sequences.The difference between CE-T1 WI FSE and 3D CE-T1 WI FSBB was statistically significant(Z=-12.566,P<0.001).There was significant difference between CE-T1 WI FSE and 3D CE-T1 WI FFE(Z=-11.184,P<0.001),but there was no significant difference between 3D CE-T1 WI FSBB and3 D CE-T1 WI FFE(Z=-1.382,P=0.501).3.Stratified analysis of lesions with maximum diameter ≤ 3 mm showed that the mean CS±SD of CE-T1 WI FSE、3D CE-T1 WI FSBB and 3D CE-T1 WI FFE were1.21±0.87,2.71±0.68 and 2.55±0.82,respectively.Bonferroni method was used for multiple comparison analysis of the mean CS±SD of the three sequences.The statistical results showed that the difference between CE-T1 WI FSE and 3D CE-T1 WI FSBB was statistically significant(Z=-12.044,P<0.001).There was significant difference between CE-T1 WI FSE and of 3D CE-T1 WI FFE(Z=-10.642,P<0.001),but there was no significant difference between the 3D CE-T1 WI FSBB and the 3D CE-T1 WI FFE(Z=-1.372,P=0.501).4.For lesions with maximum diameter of 3-10 mm,the mean CS±SD of CE-T1 WI FSE 、 3D CE-T1 WI FSBB and 3D CE-T1 WI FFE were 2.65±0.57,2.96±0.20 and 2.91±0.34,respectively.Bonferroni method was used for multiple comparison analysis of the mean CS±SD of the three sequences.The statistical results showed that the difference between CE-T1 WI FSE and 3D CE-T1 WI FSBB was statistically significant(Z=-6.712,P<0.001).There was significant difference between CE-T1 WI FSE and 3D CE-T1 WI FFE(Z=5.841,P<0.001),but there was no significant difference between 3D CE-T1 WI FSBB and 3D CE-T1 WI FFE(Z=0.839,P>0.999).5.Among the 320 lesions,83 lesions(83/320,25.94%)were detected by 3D CE-T1 WI FSBB,including 69 lung adenocarcinomas,9 lung small cell carcinomas,4lung squamous cell carcinomas and 1 lung adenosquamous carcinomas.6.Of the 6 320 lesions,219(219/320,68.44%)were supratentorial metastases,most commonly in the frontal lobe,71(71/320,22.19%)were infratentorial metastases,and 30(30/320,9.37%)were both supratentorial and infratentorial metastases.The enhancement patterns of 320 lesions were mixed enhancement in 148lesions(46.25%),annular enhancement in 98 lesions(30.62%)and parenchymal enhancement in 74 lesions(23.13%).Conclusions:1.In the detection of brain metastases from lung cancer,3D CE-T1 WI FSBB sequence is superior to conventional CE-T1 WI FSE sequence,especially for small metastatic lesions less than or equal to 3 mm.3D CE-T1 WI FSBB and 3D CE-T1 WI FFE sequences have the same sensitivity in the detection of brain metastases,and 3D CE-T1 WI FSBB is more obvious in showing metastases,which provides rich image reference information for early clinical diagnosis and treatment.2.When metastatic tumors are complicated with hemorrhage,3D CE-T1 WI FSBB can clearly show the hemorrhage and the enhancement area of metastatic tumors,which provides a new basis for clinical treatment decision-making and is worthy of clinical application.3.Study on the location and enhancement pattern of brain metastases from lung cancer is beneficial to the diagnosis and differential diagnosis of brain metastases and primary lung cancer. |
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